Evidence Based Medicine some ramblings

Medical profession is always regarded as one of the best and noble professions of human civilization. Does it still hold the respect and regard which it accrued over a century? Is it worth considering medical profession as a job in the wake of new Evidence based medicine practice? Does studying for almost a decade in the med school and spending the most of your lively 20-30 in libraries get any better for your miserable life?

I will try to examine the present situation of med practice around the globe. Typically a student who is aspiring for joining a med school starts his preparation by spending on average 2-3 years at premed and performing very well in the MCAT exam. He will take a deep sigh in getting a great score and spends some time in different kind of volunteer and social activities apart from his pre med grades. He competes with his fellow nerds to gain entry into med school and starts his dream MD program. Here starts a huge drama of med school. You are supposed to do your best in the school by memorizing and mugging up the complicated text books. It doesn’t end there. As you complete your third year of med school, you will start preparing for the licensing exams. So, again another round of freaking tests for getting into residencies. You really need to toil down to get great scores. Finally you end up in a residency program which takes on an average 3-4 years and takes most of your quality time and ties you to either library or ICU rotations. Once you survive the hardship of studying for years your brain is literally exhausted. You are ready to take up a job. I am not following with the debt you incurred all along this path. It’s around 100-150 grand depending upon where you completed the MD program. Naturally one looks for the best hospital or a corporate entity where he looks for maximum compensation, to take care of his educational loan. How would a corporate company would practice? I guess you know the answer. It tries to squeeze as much as it could from the insurance companies to run its company, pay the physicians. So, your compensation will be based on the number of patients you would see every day and the dynamic targets you reach each and every day. There is no scope for you to understand the clinical case with the expertise you have learned all along the way for ten years by mugging dozens of text books. You are concerned with the patients out come with the maximum technology you can use. The maximum technology utilization leads to higher profits and eventually your compensation. Your compensation is directly proportional to the use of very high end diagnostic tests. Medical professionals have given a fancy name for this kind of camouflage relationship, “Evidence based medicine”. In this process your practice evidence based medicine concepts and loads of material you read and relished for long time slowly sneaks away from your grey matter. Down the lane what you remember is a hand book of medicine with different testing and prescription options. Well those things are also not have to be remembered by you since we have now high tech software programs and infinite memory disks flooded in the market to store and think about the ways as you perform. So, bottom line is you end up a clerical job clicking some screens and giving pills. You will never realize the fact that you are doing such kind of a no exciting work after toiling 10 years of your life. Who is benefited here? You?

Patient? Corporate entity? Or Insurance companies? Let me put the question in another way, who is most affected with this paradox? Straight answer is Patient and Insurance payers. Paying insurance is an insensible loss of income for most of us who are having a job. It’s a burden for who are jobless. How to correct the problems associated with it? It’s not of scope of my understanding and nor I would take stand on any side. My only frustration is about making physicians dumb and degrades their job profile to a clerical job. If that’s the case, the whole program should be revamped and there should be actually two kinds of jobs. One who just complete an undergrad program like stuff where he solely concentrates on learning the hand books of medicine and learning some standard surgical techniques. It reduces a lot of reading and happy years for the students. This would encourage more students to pursue the course and we can get more number of doctors. This in turn would reduce the MD/patient ratio. Another course of study would focus on more of medical research and design of new protocols which can be incorporated into the hand books for the other group of students. This curriculum can be little bit rigorous and intake should be limited making it competitive. This gives us the best designers of the programs of medicine.

What do you think? I guess it might work if I am a decision maker!!!!!! Well I am not...These are just ramblings….Do comment on parts you think are simply out of the way…..